TIME Nigeria

As Boko Haram Strengthens, Terrified Locals Flee Major Nigerian City

Internally displaced persons, who are victims of Boko Haram attacks, stay at the IDP camp at Wurojuli
Internally displaced persons, who are victims of Boko Haram attacks, stay at the IDP camp for those fleeing violence from Boko Haram insurgents at Wurojuli, Gombe State Sept. 2, 2014. Reuters

Nigerian troops have floundered against the Islamist militants

Hundreds of people are believed to have fled the capital of Nigeria’s northeastern Borno state as Boko Haram militants continue to sweep unabated through the region and terrified locals doubt that the deflated Nigerian military will be able to protect them.

Nigerian officials are increasingly warning that the Islamist militant group might advance on Maiduguri, capital of the besieged state, and home to some 2 million people, the New York Times reports. Boko Haram, waging a barbarous campaign of violence, has over the summer quickly collected several municipalities in the northeast, some of which officials say could be used as bases from which the militants could close in on Maiduguri.

In an alarming harbinger earlier this week, Boko Haram fighters captured the town of Bama, about 45 miles from Maiduguri and a linchpin in the jihadists’ campaign to vanquish all of Borno. Government forces had rebuffed the militants during an initial siege on Monday, but the extremist group returned en masse the following day to overwhelm the town, according to Reuters.

A soldier who fought at Bama also told Reuters that government air reinforcements botched an air strike near the end of the battle, dropping bombs on parts of the town and killing everyone there — including insurgents, but also Nigerian troops.

Boko Haram fighters patrolling Bama have since prevented anyone from burying the dead, and bodies are rotting in its streets, the BBC reports. More than 26,000 people are believed to have fled the fallen town.

Meanwhile, a recent report from Chatham House, a London-based policy group, said the Nigerian army is failing, and will continue to fail, to battle back Boko Haram fighters, in large part because locals do not trust the national armed forces. Amnesty International has accused government troops of war crimes, including torturing suspected Boko Haram loyalists.

In late August, Boko Haram declared an Islamic caliphate in the land it has so far gathered up in northeast Nigeria, near the nation’s border with Cameroon. The group, dovetailing the Islamic State of Iraq and Greater Syria’s ominous promises for the towns and cities it has taken in the Middle East, has said the claimed territories will be ruled under strict Islamic law.

Hundreds of schoolgirls from Chibok, also in Borno, are still missing, almost five months after they were snatched by Boko Haram militants.

TIME Infectious Disease

Ebola Spreads to Southern Nigeria With 3 Cases Confirmed and 60 at ‘High Risk’

An aerial view of the oil hub city Port Harcourt in Nigeria's Delta region
An aerial view of the oil hub city Port Harcourt in Nigeria's Delta region May 16, 2012. Akintunde Akinleye / Reuters—REUTERS

WHO officials warn that the epidemic is accelerating rapidly

Correction appended, Sept. 4.

Three cases of Ebola have been identified in the southern Nigerian city of Port Harcourt, the World Health Organization (WHO) says, confirming that the disease has spread outside Lagos, where five people have died.

Officials in Port Harcourt — a teeming city of 1.4 million in the Niger delta — are now monitoring over 200 people, 60 of whom are considered at high risk of having contracted the disease. It is a worrying expansion of an epidemic that has now killed 1,900 in West Africa and defied the attempts of under-staffed and under-funded aid teams to halt it.

WHO officials warn that the virus is not just expanding geographically but also accelerating. Ebola has now sickened upwards of 3,500 people and in the past week alone almost 400 people have died of the virus, said Dr. Margaret Chan, director-general of the WHO at a press conference in Washington D.C. on Wednesday.

“This Ebola epidemic is the longest, the most severe and the most complex we’ve ever seen,” said Chan. Experts, she added, “have never seen anything like it.”

Some $600 million in supplies will now be needed to duel with the epidemic, the worst on record, WHO officials said—up $110 million from the estimate given last week, according to Reuters. The increased sum will further test the willingness of the global community to tackle the disease at source. Health organizations such as Doctors Without Borders have already been highly critical of what they say is a lackluster international response.

As the epidemic expands, resources on the ground have not, WHO officials said. There is no room in what few hospitals there are in the worst-hit areas; terrified medical staff have stopped showing up to work; and in Liberia the bodies of Ebola victims are being left unattended in the streets. Some who contract the disease are also choosing to hide their illness—in the meantime, unwittingly infecting those around them—rather than be turned upon by neighbors.

Meanwhile, some 150 scientists and experts convened Thursday at the WHO’s headquarters in Geneva, Switzerland, for a two-day meeting to review available experimental Ebola drugs and vaccines and draft testing plans for the most promising. None of the drugs have been tested in humans, but one of them, ZMapp, was given to two Ebola patients who survived their illness.

On Tuesday, the U.S. Department of Health and Human Services awarded a contract worth up to $42.3 million to ZMapp’s manufacturer, jump-starting clinical trials and fresh production of the drug, supplies of which are currently tapped out.

The W.H.O estimates that Ebola will take 20,000 more lives before its transmission is stopped.

Correction: The original version of this story incorrectly identified the capital of Nigeria. It is Abuja.

Footage of life in Dolo Town, some 40 miles (60 k.m.) east of Monrovia, Liberia, which has been quarantined to contain the spread of Ebola.

TIME Infectious Disease

How Nigeria Is Keeping Ebola at Bay

APTOPIX Nigeria Ebola
Nigeria health officials wait to screen passengers at the arrival hall of Murtala Muhammed International Airport in Lagos, Nigeria, Aug. 4, 2014. Sunday Alamba—AP

Fears that Africa's most populous country would become a tinderbox for the disease have so far not come to fruition

Ebola is still running rampant in parts of West Africa. Over 1,500 people have died in Guinea, Sierra Leone and Liberia, where authorities have risked unrest by imposing nationwide curfew and quarantine zones.

But in nearby Nigeria, the government has largely contained Ebola in a single cluster traced back to the first imported case, and reported a total of only six deaths. The death of a doctor in Port Harcourt, in the south of the country, initially raised fears of a second outbreak when it was revealed on Thursday—but it soon emerged that his infection was also linked to the first Ebola case.

Health experts say that while more Ebola cases can’t be ruled out, Nigerian authorities quickly and effectively reacted to contain the disease, tracking people who had contact with patients, conducting widespread testing and quarantining suspected victims. “The response of the government has been robust,” said John Vertefeuille, who leads the Nigeria Ebola response team of the U.S. Centers for Disease Control and Prevention (CDC).

Ebola arrived in Nigeria on July 20, when Liberian-American financial consultant Patrick Sawyer flew from Liberia to Lagos, Nigeria’s commercial capital. Sawyer collapsed at the airport and was taken immediately to hospital, reducing chances of infecting more people in Lagos, a city of more than 21 million people.

He infected a few people before he was isolated, as doctors didn’t initially suspect Ebola and didn’t take full precautions. All other confirmed cases were traced back to him; eight have recovered, with only one case still being treated in isolation.

When the government realized Ebola had arrived on Nigerian soil, it acted quickly to coordinate international health organizations including the CDC, the World Health Organization, and recently Médecins Sans Frontières. It invited those groups to “come to the table and… insert themselves into those structures that the government has formed,” said Vertefeuille.

The work is divided into the management of confirmed cases who are treated in an isolation center in Lagos, and epidemiology and contact tracing, key to containing the virus.

Confirmed cases are treated in isolation, while those the victims made contact with pre-diagnosis are visited daily at their homes. If they develop symptoms, they too are taken to quarantine and tested. Nigeria began its program of contact tracing with Sawyer, and currently has more than 100 people under surveillance in Lagos.

But one man slipped through the net, Health Minister Onyebuchi Chukwu said Thursday. A Nigerian man who had contact with Sawyer developed symptoms and evaded surveillance, traveling to the oil industry hub of Port Harcourt last month, where he was treated by a doctor for his symptoms.

The man recovered and returned to Lagos four days later, after a manhunt for him had begun. The doctor, however, had contracted the virus and died on Aug. 22. The government has now begun contact tracing for him, and 70 people are now under surveillance there.

The man who escaped surveillance was an isolated case, Chukwu said. The fact that most people being treated at hospital have survived and were soon discharged has encouraged people under surveillance to cooperate. “Initially when we started we had one or two stubborn cases, but now they’re all cooperating,” he said.

As well as taking a rapid response approach to Ebola cases, the government has also been acting to stop the spread of misinformation about the disease. It has been issuing bulletins explaining how the disease spreads, and attempting to dispel rumors about unorthodox “cures” that have spread on the streets and on social media.

Benjamin Akinola, a 65-year-old retired army officer, said he and his wife bathed with and drank water with salt after a rumor suggested it could prevent Ebola. They stopped after hearing on the radio that it led to the death of some people. “People stopped it, and this is what the government is telling us,” said Akinola.

The government has also been pushing for better personal hygiene practice. Guards at supermarkets, banks, restaurants, and clubs will often spray people’s hands with sanitizers before entering.

The public relations operation seems to be working. Lawrence Obioha, a 43 year old newspaper seller in Lagos said initially fewer people attended his Sunday church service out of fear of Ebola. “Gradually it’s picking up,” he said. “There’s a lot of relief now that they know that at least there’s a response to treatment.”

While fears that Africa’s most populous country would become a breeding ground for the disease have so far proven unfounded, officials in Nigeria are under no illusion that the virus has been stamped out. “We have not eliminated the disease. We have not eradicated it,” said Chukwu. Over 200 remain under observation, and the infection is still raging in Sierra Leone, Guinea and Liberia. The battle against Ebola will continue in Nigeria for some time yet.

“This really could be a long and a hard fight,” said David Daigle, a spokesman for the CDC team on Ebola in Nigeria. “We’re optimistic, but we know that this is like a forest fire and if there’s just one ember left in place it could easily start back up.”

TIME Innovation

Five Best Ideas of the Day: August 28

1. New Orleans is at the heart of a new HIV epidemic, and only massive health system reform can remedy the situation.

By Jessica Wapner in Aeon

2. From dismantling Syria’s chemical arsenal to hunting down Joseph Kony, America’s military missions abroad far outlast the public’s attention span.

By Kate Brannen in Foreign Policy

3. To look beyond stereotypes and understand the programs and interventions that improve life for young men of color, the U.S. Department of Education invited them to a “Data Jam.”

By Charley Locke in EdSurge

4. Taking a page from silicon valley, incubators for restaurateurs can help get new ideas on the plate.

By Allison Aubrey at National Public Radio

5. So the homeless can work, worship, and transition to normal life, cities should offer safe, flexible storage options.

By Kriston Capps in Citylab

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Infectious Disease

Nigeria Confirms First Ebola Death Outside Lagos

Nigeria Ebola
Nigerian health officials wait to screen passengers at the arrival hall of Murtala Muhammed International Airport in Lagos, Nigeria on Aug. 4, 2014. Sunday Alamba/AP

Doctor who died in southeastern city marks Nigeria's sixth Ebola death

Nigeria confirmed Thursday the country’s first Ebola-related death outside Lagos, the country’s main international transit hub.

The victim, an unnamed doctor who died in the southeastern oil city of Port Harcourt, marks Nigeria’s sixth Ebola death in a recent outbreak of the disease primarily affecting West Africa. He is believed to have been infected by a man linked to Nigeria’s first Ebola case, Patrick Sawyer, who died in Lagos shortly after arriving there from Liberia.

The yet-unnamed doctor had died last Friday, but Nigerian Health Minister Onyebuchi Chukwu waited until Thursday to confirm the case, the BBC reports. The doctor’s wife has been put under quarantine, while an additional 70 people suspected to have had contact with him are being monitored in Port Harcourt.

While the death marks a blow to Nigeria’s efforts to contain the disease, Mr. Chukwu noted that while “the problem is not over . . . Nigeria is doing well on containment, all the disease in Nigeria were all traced to Patrick Sawyer.”

The Nigerian government said Wednesday that schools in the country would not reopen until October 13 in order to help prevent the outbreak from spreading.

Recent figures from the World Health Organization suggest Ebola has infected more than 3,000 people and killed over half of its victims, largely in West Africa. More than 240 health workers have been infected with the deadly virus, for which there is no vaccine or cure, though it is treatable and survivable. Ebola is not airborne, and is spread only when humans come into contact with the bodily fluids of those infected with the virus.

West Africa’s health ministers will be meeting later Thursday to discuss measures to address what’s become the largest-ever Ebola epidemic.

[BBC]

TIME Infectious Disease

Here’s How Ebola Spread in the Democratic Republic of Congo: WHO

A suspected Ebola outbreak in the Democratic Republic of Congo may have no connection to the outbreak in West Africa

On Tuesday, the Democratic Republic of Congo reported to the World Health Organization (WHO) that the country is having an outbreak of Ebola, which appears to be separate and unrelated to the outbreak in West Africa.

According to the information given to the WHO and provided to media, here’s how it spread: The first person to contract Ebola in the Democratic Republic of Congo was a pregnant woman who butchered a bush animal given to her by her husband. She was taken to a clinic after she started displaying symptoms of Ebola virus disease and died on Aug. 11 of a hemorrhagic fever, that at the time, was not yet identified as Ebola. The woman died, and was dealt with by health care workers.

The health care workers who cared for the woman, which included one doctor, two nurses, a hygienist and a ward boy, all developed similar symptoms and died. Similar deaths were discovered among relatives of the first pregnant woman, people who were in contact with the health care workers, and people who were involved in the burial process of all the men and women who died. According to the WHO, from July 28 to August 18 there have been 24 suspected cases of the disease there, which includes 13 deaths.

Currently, samples of those infected are being tested for Ebola.

The Democratic Republic of Congo Ministry of Health is currently monitoring the situation and is undergoing contact tracing with support from WHO.

TIME ebola

Nigeria Confirms 2 New Ebola Cases

Nigeria Ebola
Nigerian health officials wait to screen passengers at the arrival hall of Murtala Muhammed International Airport in Lagos, Nigeria on Aug. 4, 2014. Sunday Alamba/AP

The two are the first infected people who didn’t have contact with the ill traveler

Nigeria’s health ministry confirmed Friday two new cases of Ebola in the country, the first people to come down with the disease who didn’t have direct contact with an infected traveler who brought the virus into the country from nearby Liberia.

Nigerian Health Minister Onyebuchi Chukwu said both newly infected people are the spouses of two caregivers who contracted the virus and later died after giving treatment to Patrick Sawyer, the Liberian-American man who flew into the country infected with the virus last month.

Sawyer passed Ebola on to 11 other individuals before he died. The two new infections plus Sawyer bring the total number of Ebola patients in Nigeria during this outbreak to 14, five of whom have died while another five have recovered.

[AP]

TIME Infectious Disease

WHO: Ebola Casualties Top 1,200

A Liberian burial team wearing protective clothing retrieves the body of a 60-year-old Ebola victim from his home on August 17, 2014 near Monrovia, Liberia.
A Liberian burial team wearing protective clothing retrieves the body of a 60-year-old Ebola victim from his home on August 17, 2014 near Monrovia, Liberia. John Moore—Getty Images

Another 84 deaths reported in just three days

The World Health Organization has tallied another 84 deaths from confirmed or probable cases of Ebola virus over the past three days, bringing the death toll in West Africa to 1,229 people.

The WHO released the updated figures on Tuesday and announced an increase in food and aid shipments to roughly 1 million people living within the quarantined areas of Guinea, Liberia and Sierra Leone.

“It is essential that people in those zones have access to food, water, good sanitation and other basic supplies,” the WHO said in a statement, adding that it had partnered with the United Nations World Food Programme to scale up its aide shipments to affected areas and target its deliveries to hospitals and quarantined homes. “Providing regular food supplies is a potent means of limiting unnecessary movement,” the organization said.

Liberia’s information minister said Tuesday that three Ebola-stricken African doctors who were treated with a regimen of the experimental drug, ZMapp have shown “remarkable signs of improvement,” Reuters reports. The minister also confirmed that 17 Ebola patients who escaped from a quarantine center in Monrovia had been found and transferred to a treatment center.

TIME Infectious Disease

WHO: Ebola Outbreak Countries Should Screen Departing Travelers

An MSF medical worker checks their protective clothing in a mirror at an MSF facility in Kailahun, Sierra Leone on August 15, 2014.
An MSF medical worker checks their protective clothing in a mirror at an MSF facility in Kailahun, Sierra Leone on August 15, 2014. Carl De Souza—AFP/Getty Images

Liberia, Guinea, Nigeria and Sierra Leone advised to conduct exit screenings to contain spread of virus

The World Health Organization (WHO) is asking countries affected by Ebola to conduct exit screenings of people leaving at international airports, seaports and major land crossings.

“Any person with an illness consistent with [the Ebola virus] should not be allowed to travel unless the travel is part of an appropriate medical evacuation. There should be no international travel of Ebola contacts or cases, unless the travel is part of an appropriate medical evacuation,” the WHO said in a statement. The West Africa outbreak has spread to Guinea, Liberia, Nigeria and Sierra Leone.

The announcement comes after a quarantine center was attacked in Liberia on Saturday. Reports suggest that around 17 Ebola-positive patients were taken from the center, which complicates efforts to track down and isolate people who may have come in contact with the disease. Blood-stained bedding was also stolen from the center, which officials warned may be able to spread the disease.

The WHO has created a Travel and Transport Task Force which will continuously monitor the outbreak in order to provide information and advice to the travel and tourism industry, but is currently not recommending any bans on international travel or trade. The WHO is also not recommending entrance screening for countries not affected by the disease and which do not share borders with affected countries.

The WHO also stressed that transmission of the virus on an airplane is a very low risk. People are contagious with Ebola once they start experiencing symptoms, and when that happens, people are usually too sick to attempt any travel. Ebola is also not an airborne disease, and can only be transmitted through direct contact with infected bodily fluids like blood and vomit. “Travelers are, in any event, advised to avoid all such contacts and routinely practice careful hygiene, like hand washing,” the WHO said.

People who are getting sick are usually family members and friends who are personally caring for a sick person or someone undergoing funeral preparations unprotected.

In a separate statement on Monday, the WHO addressed the threats experienced by health workers fighting Ebola. “Assaults on health workers and facilities seriously affect access to health care, depriving patients of treatment and interrupting measures to prevent and control contagious diseases. WHO has a specific mandate to protect the human right to health, especially for people affected by humanitarian emergencies,” Dr. Richard Brennan, director of WHO’s department of emergency risk management and humanitarian response said.

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